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1.
M. Spacek O. Belohlavek J. Votrubova P. Sebesta P. Stadler 《European journal of nuclear medicine and molecular imaging》2009,36(5):850-858
Introduction Vascular prosthesis infection (VPI) is a life-threatening complication that occurs in 0.5–5% of prostheses. Low-grade infections
in non-acute patients are a diagnostic challenge requiring a new method with good diagnostic accuracy. The aim of this work
was to define the accuracy of 18F-FDG PET/CT in these settings and to identify essential parameters of the evaluation.
Material and methods PET/CT was performed prospectively in 76 consecutive patients with a total of 96 vascular prosthetic grafts in which infection
was suspected. PET/CT scans were analysed in terms of the presence and intensity of focal and diffuse FDG uptake, the presence
of an anastomotic pseudoaneurysm, the presence of an irregular boundary of infiltration, a combination of these, and the uptake
ratio between the graft and blood background. The gold standard was based on operative/histopathological finding or a clinical
follow up of >6 months.
Results Among the various assessed parameters only focal FDG uptake and an irregular graft boundary were significant predictors of
VPI. Focal intense FDG uptake together with an irregular boundary of the lesion on CT scan predicted VPI with 97% probability,
while smooth lesion boundaries and no focal FDG uptake predicted a probability of VPI of less than 5%. Even in lesions with
nondiagnostic inhomogeneous focal FDG uptake (18/96) an irregular boundary effectively helped in decision-making with a probability
of 28% (smooth) or 77% (irregular) for VPI.
Conclusion PET/CT gave reliable results with an accuracy >95% in 75% of prostheses. PET/CT can identify those prostheses (25% of prosthesis)
for which its diagnostic accuracy is diminished to 70–75%. In our series PET/CT was an excellent diagnostic modality for suspected
VPI. 相似文献
2.
Objective
We investigated the prevalence and clinical significance of incidental focal 18F-FDG uptake in the frontal process of the maxilla, mimicking malignancy on PET/CT.Methods
From a total of 32,834 patients who underwent 18F-FDG PET/CT, patients with focal uptake in the frontal process of the maxilla were selected by a database search. For those patients, medical records including relevant imaging studies were reviewed.Results
Thirty-nine patients (0.12 %) demonstrated focal uptake on PET/CT. On CT of PET/CT, all lesions showed ground-glass attenuation with or without bony expansion, consistent with fibrous dysplasia. When comparing previous PET/CT, follow-up PET/CT, and CT, a significant difference in degree of 18F-FDG uptake was noted, with no associated change in the size of maxillary lesions. There were no patients who had symptoms or signs related to maxillary lesions during follow-up.Conclusion
Focal 18F-FDG uptake in the frontal process of the maxilla is a rare, incidental, and persistent finding with variable uptake and can represent a benign condition.3.
Chae Hong Lim Seung Hyup Hyun Seung Hwan Moon Young Seok Cho Yearn Seong Choe Kyung-Han Lee Byung-Tae Kim Joon Young Choi 《Nuclear Medicine and Molecular Imaging》2017,51(3):247-251
Purpose
We investigated the incidence, location, and clinical significance of focal 18F-FDG uptake of the spinal cord in patients with cancer.Methods
We reviewed the medical records of 22,937 consecutive adult patients with known or suspicious malignancy who underwent 18F-FDG PET/CT. PET/CT scans with incidental focal spinal cord uptake were selected and retrospectively reviewed to determine the presence, location, number, and maximum standardized uptake value (SUVmax) of any focal hypermetabolic lesions of the spinal cord. In subjects with focal spinal uptake, clinical characteristics and clinical follow-up results, including follow-up PET/CT, were reviewed.Results
Incidental focal spinal cord uptake was observed in 69 of 22,937 adult patients (incidence?=?0.3%; M:F?=?31:38; age, 55.8?±?14.7 years). Seventy-eight focal hypermetabolic lesions on spinal cord in the PET/CT scans of the 69 study subjects were analyzed. The most common sites of focal spinal cord uptake were the T12 vertebra (47/78; 60.3%) and L1 vertebra (20/78; 25.6%). Multifocal cord uptake was found in 8 of 69 patients (11.6%). The average SUVmax for cord uptake was 2.5?±?0.5 (range, 1.4~3.9). There was no clinical or imaging evidence of abnormalities in the spinal cord, both at the time of PET/CT and during clinical follow-up.Conclusions
Although incidental focal 18F-FDG uptake of the spinal cord is rare in patients with cancer, it may be physiological or benign, but it should not be considered as malignant involvement. Common sites for the uptake were in the T12 and L1 spine levels.4.
Background
Acute complicated pyelonephritis (ACP) is an upper urinary tract infection associated with coexisting urinary tract abnormalities or medical conditions that could predispose to serious outcomes or treatment failures. Although CT and magnetic resonance imaging (MRI) are frequently used in patients with ACP, the clinical value of 18F–fluorodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT) has not been systematically investigated. This single-center retrospective study was designed to evaluate the potential usefulness of FDG PET/CT in patients with ACP.Methods
Thirty-one adult patients with ACP who underwent FDG PET/CT were examined. FDG PET/CT imaging characteristics, including tracer uptake patterns, kidney volumes, and extrarenal imaging findings, were reviewed in combination with clinical data and conventional imaging results.Results
Of the 31 patients, 19 (61%) showed focal FDG uptake. The remaining 12 study participants showed a diffuse FDG uptake pattern. After volumetric approximation, the affected kidneys were found to be significantly enlarged. Patients who showed a focal uptake pattern had a higher frequency of abscess formation requiring drainage. ACP patients showing diffuse tracer uptake patterns had a more benign clinical course. Seven patients had suspected extrarenal coinfections, and FDG PET/CT successfully confirmed the clinical suspicion in five cases. FDG PET/CT was as sensitive as CT in identifying the six patients (19%) who developed abscesses. Notably, FDG PET/CT findings caused a modification to the initial antibiotic regimen in nine patients (29%).Conclusions
FDG PET/CT may be clinically useful in the assessment of patients with ACP who have a progressive disease course.5.
Suk Kyong Cho Joon Young Choi Jang Yoo Miju Cheon Ji Young Lee Seung Hyup Hyun Eun Jeong Lee Kyung-Han Lee Byung-Tae Kim 《Nuclear Medicine and Molecular Imaging》2011,45(3):192-196
Purpose
The extent and intensity of 18F-FDG uptake in prostate cancer patients are known to be variable, and the clinical significance of focal 18F-fluorodeoxyglucose (18F-FDG) uptake that is incidentally found on positron emission tomography (PET) has not been established. We investigated the clinical significance of incidental focal prostate uptake of 18F-FDG on PET/computed tomography (CT) and analyzed differential findings on PET/CT between malignant and benign uptake.Methods
A total of 14,854 whole-body 18F-FDG PET/CT scans (4,806 that were conducted during cancer screening and 10,048 that were conducted to evaluate suspected or alleged cancer outside of the prostate) were retrospectively reviewed to determine the presence, location, multiplicity and maximum standardized uptake value (SUVmax) of focal prostate uptake and combined calcification. The final diagnosis determined by serum prostate-specific antigen (PSA) level and biopsy was compared with PET findings.Results
Incidental focal prostate uptake was observed in 148 of 14,854 scans (1.0 %). Sixty-seven of these 148 subjects who had diagnostic confirmation were selected for further analysis. Prostate cancer was diagnosed in nine of 67 subjects (13.4%). The remaining 58 subjects had no malignancy in the prostate based on normal serum PSA level (n = 53), or elevated serum PSA level with a negative biopsy result (n = 5). While 84.6% (11/13) of malignant uptake was peripherally located in the prostate glands, 60.2% (50/83) of benign uptake was centrally located (p < 0.05). The positive predictive value of peripheral focal uptake for malignancy was 25%. The SUVmax, multiplicity and combined calcification were not significantly different between the two groups.Conclusion
Although incidental focal 18F-FDG uptake in the prostate is not common, the incidence of cancer with focal uptake is not low. Therefore, these findings deserve further evaluation. The location of the focal prostate uptake may help with the selection of high-risk prostate cancer patients. 相似文献6.
Roy Harnish Sven Prevrhal Abass Alavi Habib Zaidi Thomas F. Lang 《Annals of nuclear medicine》2014,28(6):540-550
Background
To determine if metal artefact reduction (MAR) combined with a priori knowledge of prosthesis material composition can be applied to obtain CT-based attenuation maps with sufficient accuracy for quantitative assessment of 18F-fluorodeoxyglucose uptake in lesions near metallic prostheses.Methods
A custom hip prosthesis phantom with a lesion-sized cavity filled with 0.2 ml 18F-FDG solution having an activity of 3.367 MBq adjacent to a prosthesis bore was imaged twice with a chrome–cobalt steel hip prosthesis and a plastic replica, respectively. Scanning was performed on a clinical hybrid PET/CT system equipped with an additional external 137Cs transmission source. PET emission images were reconstructed from both phantom configurations with CT-based attenuation correction (CTAC) and with CT-based attenuation correction using MAR (MARCTAC). To compare results with the attenuation-correction method extant prior to the advent of PET/CT, we also carried out attenuation correction with 137Cs transmission-based attenuation correction (TXAC). CTAC and MARCTAC images were scaled to attenuation coefficients at 511 keV using a trilinear function that mapped the highest CT values to the prosthesis alloy attenuation coefficient. Accuracy and spatial distribution of the lesion activity was compared between the three reconstruction schemes.Results
Compared to the reference activity of 3.37 MBq, the estimated activity quantified from the PET image corrected by TXAC was 3.41 MBq. The activity estimated from PET images corrected by MARCTAC was similar in accuracy at 3.32 MBq. CTAC corrected PET images resulted in nearly 40 % overestimation of lesion activity at 4.70 MBq. Comparison of PET images obtained with the plastic and metal prostheses in place showed that CTAC resulted in a marked distortion of the 18F-FDG distribution within the lesion, whereas application of MARCTAC and TXAC resulted in lesion distributions similar to those observed with the plastic replica.Conclusions
MAR combined with a trilinear CT number mapping for PET attenuation correction resulted in estimates of lesion activity comparable in accuracy to that obtained with 137Cs transmission-based attenuation correction, and far superior to estimates made without attenuation correction or with a standard CT attenuation map. The ability to use CT images for attenuation correction is a potentially important development because it obviates the need for a 137Cs transmission source, which entails extra scan time, logistical complexity and expense. 相似文献7.
James Yuheng Jiang Marco Lee Christine Kang Veronica Chi Ken Wong Robert Mansberg 《Radiology Case Reports》2021,16(11):3569
Although primary cardiac tumours are extremely uncommon, secondary tumours or cardiac metastasis are not. We present a 68-year-old gentleman with squamous cell carcinoma of the right lower lobe with bony metastasis to the right clavicle who was treated with radiotherapy to the lung and clavicle as well as combination immunotherapy (Pembrolizumab) and chemotherapy (Carboplatin/Paclitaxel). Despite completing the above treatment regime, 18F-FDG PET/CT scan showed progression with two new sites of metastasis including a focus in the lateral wall of the right ventricle which correlate to a soft tissue density mass on CT as well as a FDG avid mass in the left masseter. Identification of cardiac lesions with 18F-FDG PET/CT maybe challenging with routine preparation due high physiological FDG uptake in the myocardium and significant variability, nevertheless, focal FDG uptake in the heart should be carefully assessed for the possibility of cardiac metastasis. 相似文献
8.
Kyu-Ho Choi Jin Kyoung Oh Sung Hoon Kim Ik Dong Yoo Eun Kyoung Choi Eun Ji Han 《Nuclear Medicine and Molecular Imaging》2011,45(1):68-71
A 77-year-old woman underwent chemotherapy, radiotherapy, and brachytherapy for cervical cancer 9 years ago. On a follow-up 18F-fluorodeoxyglucose (FDG) PET/CT image, focal FDG uptake was noted in a focal osteolytic lesion in the right femoral head. During magnetic resonance imaging, this lesion showed subchondral dark-signal-intensity rim on T1-weighted image and double line sign on T2-weighted image, suggestive of osteonecrosis. The lesion was pathologically confirmed as osteonecrosis after surgery. This case demonstrates that osteonecrosis of the femoral head may demonstrate focal FDG uptake mimicking bone metastasis. 相似文献
9.
Siddharth A. Padia Adam Alessio Sharon W. Kwan David H. Lewis Sandeep Vaidya Satoshi Minoshima 《Journal of vascular and interventional radiology : JVIR》2013,24(8):1147-1153
PurposeTo compare positron emission tomography/computed tomography (PET/CT) imaging with bremsstrahlung single photon emission computed tomography (SPECT) in patients after yttrium-90 (90Y) microsphere radioembolization to assess particle uptake.Materials and MethodsThis prospective study comprised patients with large (> 5 cm) hepatocellular carcinoma (HCC) or tumor-associated portal vein thrombus (PVT), or both. After radioembolization for HCC, patients underwent bremsstrahlung SPECT/CT and time-of-flight PET/CT imaging of 90Y without additional tracer administration. Follow-up imaging and toxicity was analyzed. Imaging analyses of PET/CT and bremsstrahlung SPECT/CT were independently performed.ResultsThere were 13 patients enrolled in the study, including 7 with PVT. Median tumor diameter was 7 cm. PET/CT demonstrated precise localization of 90Y particles in the liver, with specific patterns of uptake in large tumors. In cases of PVT, PET/CT showed activity within the PVT. When correlated to short-term follow-up imaging, areas of necrosis correlated with regions of uptake seen on PET/CT. Compared with bremsstrahlung imaging, PET/CT demonstrated at least comparable spatial resolution with less scatter. Quantitative uptake in nontreated regions of interest showed significantly reduced scatter with PET/CT versus SPECT/CT (1% vs 14%, P < .001).ConclusionsEvaluation of 90Y particle uptake with PET/CT potentially demonstrates high spatial resolution and low scatter compared with bremsstrahlung SPECT/CT. Confirmation of particles within PVT on PET/CT correlates with response on follow-up imaging and may account for the efficacy of radioembolization in patients with PVT. 相似文献
10.
Rin Yamaguchi Yasuhiko Futamata Fumihiro Yoshimura Naotaka Murakami Kikuo Koufuji Rumiko Kutami Kazuyuki Kojima Shino Ohki Seiji Kurata Hayato Kaida Masatoshi Ishibashi Hirohisa Yano 《Japanese journal of radiology》2009,27(7):280-284
Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) has been shown to be an effective and accurate diagnostic technique for breast cancer. However, benign breast lesions have also been reported to show a false-positive FDG uptake on PET. We present two cases of benign tumors that revealed FDG uptake on PET and were difficult to distinguish from breast cancer. A 46-year-old premenopausal woman noticed a mass in her right breast. Ultrasonography showed a hypoechoic mass with the size of 7.7 × 3.9 mm and an irregular shape in the right breast. PET demonstrated a focal accumulation of FDG with a maximum standardized uptake value (SUVmax) of 2.1. Excisional biopsy was performed, and ductal adenoma was diagnosed. In the second case, a 36-year-old premenopausal woman was pointed out as showing an abnormality in the left breast on screening mammography. Ultrasonography showed a hypoechoic mass of 1.5 × 1.2 cm in size in the left breast. The lesion was depicted as a mass with prominent enhancement on dynamic CT and a focal accumulation of FDG with SUV max of 3.5 on PET. It was diagnosed as fibroadenoma of mastopathic type histopathologically by excisional biopsy. The readers should be aware that these benign tumors may cause false-positive results on PET. 相似文献
11.
Duygu Has Şimşek Yasemin Şanlı Serkan Kuyumcu Bora Başaran Ayşe Mudun 《Annals of nuclear medicine》2018,32(4):297-301
Objective
The aim of this study was to present our experience in the baseline evaluation of carotid body paragangliomas (CBP) with 68Ga-DOTATATE PET–CT.Methods
Five patients (4F, 1M; age 24–73 years) with CBPs who underwent 68Ga-DOTATATE PET–CT scan before the treatment were evaluated retrospectively. PET–CT images were analyzed visually as well as semiquantitatively, with measurement of maximum standardized uptake value (SUVmax).Results
All patients had unilateral CBP lesion, showed intense 68Ga-DOTATATE uptake in PET–CT. Additionally, 68Ga-DOTATATE avid lesions were found in two patients. One of them had focal intense uptake in thyroid gland and frontal cerebrum. The other one had intense uptake in bone and adrenal mass. Four patients were operated for unilateral primary CBP. Last patient was treated with peptide receptor radionuclide therapy (177Lu-DOTATATE) for both metastatic pheochromocytoma and CBP.Conclusions
68Ga-DOTATATE PET–CT is a valuable imaging modality for staging of CBPs, detecting unknown lesions and changing the management of patients. It is also useful in demonstrating expression of SSTRs for PRRT opportunity.12.
Chieh Lin Chi-Lai Ho Shu-Hang Ng Po-Nan Wang Yenlin Huang Yu-Chun Lin Tzung-Chih Tang Shu-Fan Tsai Alain Rahmouni Tzu-Chen Yen 《European journal of nuclear medicine and molecular imaging》2014,41(1):41-49
Purpose
We investigated the potential value of 11C-acetate (ACT) PET/CT in characterizing multiple myeloma (MM) compared with 18F-FDG PET/CT. Bone marrow histological and whole-body (WB) MRI findings served as the reference standards.Methods
In this prospective study, 15 untreated MM patients (10 men and 5 women, age range 48?69 years) underwent dual-tracer 11C-ACT and 18F-FDG PET/CT and WB MRI for pretreatment staging, and 13 of them had repeated examinations after induction therapy. Diffuse and focal bone marrow uptake was assessed by visual and quantitative analyses, including measurement of the maximum standardized uptake value (SUVmax). Between-group differences and correlations were assessed with the Mann-Whitney U test and the Pearson test.Results
At staging, all 15 patients had diffuse myeloma involvement upon bone marrow examination with 30–90 % of plasma cell infiltrates. Diffuse infiltration was detected in all of them (100 %) using 11C-ACT with a positive correlation between bone marrow uptake values and percentages of plasma cell infiltrates (r = +0.63, p?=?0.01). In contrast, a diagnosis of diffuse infiltration could be established using 18F-FDG in only six patients (40 %). Focal lesions were shown in 13 patients on both 11C-ACT PET/CT and WB MRI, and in 10 patients on 18F-FDG PET/CT. Focal lesions demonstrated 11C-ACT uptake with a mean SUVmax of 11.4 ± 3.3 (range 4.6?19.6, n?=?59), which was significantly higher than the 18F-FDG uptake (mean SUVmax 6.6 ± 3.1, range 2.3?13.7, n?=?29; p?<?0.0001). After treatment, the diffuse bone marrow 11C-ACT uptake showed a mean SUVmax reduction of 66 % in patients with at least a very good partial response versus 34 % in those with at most a partial response only (p?=?0.01).Conclusion
PET/CT using 11C-ACT as a biomarker showed a higher detection rate for both diffuse and focal myeloma lesions at diagnosis than using 18F-FDG, and may be valuable for response assessment. 相似文献13.
Diana Litmanovich Konstantin Gourevich Ora Israel Zahava Gallimidi 《European journal of nuclear medicine and molecular imaging》2009,36(10):1558-1564
Purpose
The aim of this study was to evaluate the frequency and clinical significance of unexpected focal 18F-fluorodeoxyglucose (FDG) uptake localized by PET/CT within the breast. 相似文献14.
Sonia L. Betancourt Cuellar Diana Palacio Marcelo F. Benveniste Brett W. Carter Gregory Gladish 《Current problems in diagnostic radiology》2019,48(2):172-183
Positron emission tomography (PET) computed tomography (CT) with 2-[fluorine-18] fluoro-2-deoxy-d-glucose (FDG) has been established as an effective modality for evaluation of cancer. Interpretations of patterns of physiologic 18F-FDG uptake by the heart is particularly difficult given the wide normal variations of 18F-FDG metabolic activity observed. Atypical patterns of focal or diffuse physiologic cardiac 18F-FDG uptake and post-therapeutic effects after radiation therapy, systemic diseases, or cardiomyopathy may also be confused with malignant disease on 18F-FDG PET/CT. In this article, we review the variations of normal cardiac 18F-FDG uptake observed in oncology patients and the appearances of other patterns of pathologic metabolic activity, related or not related to the malignancy being investigated, that may lead to false-negative and false-positive results. 相似文献
15.
A 56-year-old man presented to the emergency department with shortness of breath during the COVID-19 pandemic. Chest computed tomography angiography (CTa) showed bilateral peripheral ground-glass opacifications classified as CO-RADS 5, but no pulmonary embolism. To analyze the possibility of CTa-undetectable pulmonary microthrombi and to rule out cardiac perfusion abnormalities, we decided to perform a rubidium-82 (82Rb) PET/CT. 82Rb PET/CT imaging in this patient yielded uptake in the pulmonary areas of ground-glass opacification and showed corresponding findings between 82Rb PET/CT and CTa imaging without any signs of microthrombi despite the elevated d-dimer. Even in the areas of profound groundglass opacifications, the increased 82Rb uptake indicates that perfusion is adequate to acquire 82Rb uptake in the pulmonary cells. 82Rb PET/CT is a promising imaging technique and might extend the diagnostic potential of conventional nuclear and radiological imaging in detecting pulmonary microthrombi or other minor perfusion defects. 相似文献
16.
Purpose
18F-FDG PET/CT (PET/CT) is a useful tool for the diagnosis of aortic graft infection (AGI), but has rarely been used to influence therapeutic decisions during follow-up. We aimed to study the role of PET/CT in the long-term monitoring of patients.Methods
Participants of the prospective Vascular Graft Infection Cohort Study (VASGRA) were included if they had microbiologically proven AGI. We quantified the metabolic activity in PET/CT by using maximum standardized uptake value (SUVmax) and further classified it as being focal or diffuse. Multivariable linear regression models were fit using generalized estimating equations to investigate factors associated with SUVmax over time.Results
Sixty-eight participants with AGI contributed to 266 PET/CTs including 36 examinations performed after stop of antimicrobial therapy. Higher C-reactive protein (CRP) (adjusted coefficient per log10 mg/L 0.05 [95% C.I. 0.02–0.08]) was associated with higher SUVmax. CRP, metabolic and clinical findings informed the decision to either start (medians of SUVmax 7.1 and CRP 31.5 mg/L; 100% focal uptake), escalate (SUVmax 9.5; CRP 31.5; 100% focal uptake), continue (SUVmax 6.0; CRP 9.95 mg/L; 90% focal uptake), or stop (SUVmax 4.3; CRP 3.5 mg/L; 61% focal uptake) antibiotic treatment. Of note, decisions to escalate or continue antibiotic treatment were taken despite normal CRP values in 12.5 and 35.7% of PET/CTs, respectively.Conclusions
Consecutive PET/CTs could influence the clinical decision-making in patients with AGI in the near future. More studies on the use of PET/CT in case of aortic graft infection may offer the potential for individualized treatment approaches.CLINICALTRIALS.GOV IDENTIFIER
NCT01821664.17.
Non-malignant FDG uptake in infradiaphragmatic adipose tissue: a new site of physiological tracer biodistribution characterised by PET/CT 总被引:2,自引:2,他引:0
Bar-Shalom R Gaitini D Keidar Z Israel O 《European journal of nuclear medicine and molecular imaging》2004,31(8):1105-1113
The purpose of this study was to characterise a benign pattern of infradiaphragmatic 18F-fluorodeoxyglucose (FDG) uptake in cancer patients using PET/CT. Infradiaphragmatic foci of FDG uptake, localised by PET/CT in regions of normal fat tissues, were demonstrated, in conjunction with fatty uptake in the neck and shoulders, in 9 of 1,241 (0.7%) patients. The imaging and clinical characteristics of this pattern and its possible clinical significance were assessed. PET/CT precisely localised infradiaphragmatic fat uptake (IDFU) within normal retroperitoneal fatty tissue of the perirenal space (nine patients) and in the paracolic or parahepatic space (four patients). Perirenal uptake was bilateral in five patients and focal in six. Paracolic and parahepatic uptake was bilateral in three patients and linear in all four patients. There was no evidence of malignancy at any of the sites during a follow-up period of 9–21 months. IDFU was significantly more prevalent in young patients assessed for monitoring response to therapy, and was always associated with the benign supradiaphragmatic uptake pattern, although its prevalence was significantly lower. There were no significant differences between the clinical characteristics of these two patterns of benign fatty FDG uptake. It is concluded that PET/CT allows for precise identification of increased FDG uptake in abdominal fatty tissue and further exclusion of disease at such sites. This benign uptake may represent increased glucose consumption in activated brown adipose tissue, similar to the mechanism suggested for supradiaphragmatic uptake. Recognition of this benign IDFU pattern is important for correct interpretation of abdominal PET findings in cancer patients. 相似文献
18.
Motoho Morita Tetsuya Higuchi Arifudin Achmad Azusa Tokue Yukiko Arisaka Yoshito Tsushima 《European journal of nuclear medicine and molecular imaging》2013,40(11):1672-1681
Purpose
The usefulness of 18F-FDG PET/CT for bone metastasis evaluation has already been established. The amino acid PET tracer [18F]-3-fluoro-alpha-methyl tyrosine (18F-FAMT) has been reported to be highly specific for malignancy. We evaluated the additional value of 18F-FAMT PET/CT to complement 18F-FDG PET/CT in the evaluation of bone metastasis.Methods
This retrospective study included 21 patients with bone metastases of various cancers who had undergone both 18F-FDG and 18F-FAMT PET/CT within 1 month of each other. 18F-FDG-avid bone lesions suspicious for malignancy were carefully selected based on the cut-off value for malignancy, and the SUVmax of the 18F-FAMT in the corresponding lesions were evaluated.Results
A total of 72 18F-FDG-positive bone lesions suspected to be metastases in the 21 patients were used as the reference standard. 18F-FAMT uptake was found in 87.5 % of the lesions. In the lesions of lung cancer origin, the uptake of the two tracers showed a good correlation (40 lesions, r?=?0.68, P?<?0.01). Bone metastatic lesions of oesophageal cancer showed the highest average of 18F-FAMT uptake. Bone metastatic lesions of squamous cell carcinoma showed higher 18F-FAMT uptake than those of adenocarcinoma. No significant difference in 18F-FAMT uptake was seen between osteoblastic and osteolytic bone metastatic lesions.Conclusion
The usefulness of 18F-FAMT PET/CT for bone metastasis detection regardless of the lesion phenotype was demonstrated. The fact that 18F-FAMT uptake was confirmed by 18F-FDG uptake suggests that 18F-FAMT PET/CT has the potential to complement 18F-FDG PET/CT for the detection of bone metastases. 相似文献19.
Joon Young Choi Kyung Soo Lee Hyung-Jin Kim Young Mog Shim O Jung Kwon Keunchil Park Chung-Hwan Baek Jae Hoon Chung Kyung-Han Lee Byung-Tae Kim 《Journal of nuclear medicine》2006,47(4):609-615
In this retrospective study, we investigated whether the (18)F-FDG uptake pattern and CT findings improved the accuracy over the standardized uptake value (SUV) for differentiating benign from malignant focal thyroid lesions incidentally found on (18)F-FDG PET/CT. We also defined the prevalence of these lesions and their risk for cancer. METHODS: (18)F-FDG PET/CT was performed on 1,763 subjects without a previous history of thyroid cancer from May 2003 to June 2004. Two nuclear medicine physicians and 1 radiologist interpreted PET/CT images, concentrating on the presence of focal thyroid lesions, the maximum SUV of the thyroid lesion, the pattern of background thyroid (18)F-FDG uptake, and the CT attenuation pattern of the thyroid lesion. RESULTS: The prevalence of focal thyroid lesions on PET/CT was 4.0% (70/1,763). Diagnostic confirmation was done on 44 subjects by ultrasonography (US)-guided fine-needle aspiration (n = 29) or US with clinical follow-up (n = 15). Among 49 focal thyroid lesions in these 44 subjects, 18 focal thyroid lesions of 17 subjects were histologically proven to be malignant (papillary cancer in 16, metastasis from esophageal cancer in 1, non-Hodgkin's lymphoma in 1). Therefore, the cancer risk of focal thyroid lesions was 36.7% on a lesion-by-lesion basis or 38.6% on a subject-by-subject basis. The maximum SUV of malignant thyroid lesions was significantly higher than that of benign lesions (6.7 +/- 5.5 vs. 10.7 +/- 7.8; P < 0.05). When only the maximum SUV was applied to differentiate benign from malignant focal thyroid lesions for the receiver-operating-characteristic curve analysis, the area under the curve (AUC) of PET was 0.701. All 16 focal thyroid lesions with very low attenuation or nonlocalization on CT images, or with accompanying diffusely increased thyroid (18)F-FDG uptake, were benign. When those lesions were regarded as benign lesions, irrespective of the maximum SUV, the AUC of PET/CT was significantly improved to 0.878 (P < 0.01). CONCLUSION: Focal thyroid lesions incidentally found on (18)F-FDG PET/CT have a high risk of thyroid malignancy. Image interpretation that includes (18)F-FDG uptake and the CT attenuation pattern, along with the SUV, significantly improves the accuracy of PET/CT for differentiating benign from malignant focal thyroid lesions. 相似文献
20.
Usefulness of <Superscript>18</Superscript>F-FDG PET in intrahepatic cholangiocarcinoma 总被引:4,自引:0,他引:4
Kim YJ Yun M Lee WJ Kim KS Lee JD 《European journal of nuclear medicine and molecular imaging》2003,30(11):1467-1472
Surgical resection is the only curative treatment strategy for intrahepatic cholangiocarcinoma (CC). Therefore, accurate staging is essential for appropriate management of patients with CC. We assessed the usefulness of 2-[18F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the staging of CC. We undertook a retrospective review of FDG PET images in 21 patients (10 female, 11 male; mean age 57 years) diagnosed with CC. Ten patients had hilar CC and 11, peripheral CC. Patients underwent abdominal magnetic resonance imaging (MRI) (n=20) and computed tomography (CT) (n=12) for the evaluation of primary tumours, and chest radiography and whole-body bone scintigraphy for work-up of distant metastases. For semi-quantitative analysis, the maximum voxel standardised uptake value (SUVmax) was obtained from the primary tumour. All peripheral CCs showed intensely increased FDG uptake, and some demonstrated ring-shaped uptake corresponding to peripheral rim enhancement on CT and/or MRI. In nine of the ten patients, hilar CCs demonstrated increased FDG uptake of a focal nodular or linear branching appearance. The remaining case was false negative on FDG PET. One patient with a false negative result on MRI demonstrated increased uptake on FDG PET. Among the ten hilar CCs, FDG uptake was intense in only two patients and was slightly higher than that of the hepatic parenchyma in the remaining patients. For the detection of lymph node metastasis, FDG PET and CT/MRI were concordant in 16 patients, and discordant in five (FDG PET was positive in three, and CT and MRI in two). FDG PET identified unsuspected distant metastases in four of the 21 patients; all of these patients had peripheral CC. FDG PET is useful in detecting the primary lesion in both hilar and peripheral CC and is of value in discovering unsuspected distant metastases in patients with peripheral CC. FDG PET could be useful in cases of suspected hilar CC with non-confirmatory biopsy and radiological findings. 相似文献